New research was presented at the American Society of Hypertension’s 2012 Annual Scientific Meeting & Exposition from May 19-22, 2012 in New York City. The features below highlight just some of the studies that emerged from the conference.
Exploring Clinical Inertia in Hypertension Control
The Particulars: Therapeutic goals are unmet in many patients with hypertension. Previous research suggests that clinical inertia—failure to adjust medication regimens after uncontrolled hypertension is identified—may play an important role in this problem.
Data Breakdown: Researchers analyzed 5 years of data to assess the association of patient and physician characteristics with clinical inertia incidence and continued uncontrolled hypertension. Among the 59% of patients who experienced clinical inertia, less than 2% of the variance in clinical inertia was attributable to physician characteristics. In patients, clinical inertia was associated with increased age, Hispanic/Latino ethnicity, obesity, and higher systolic and diastolic blood pressure. Take
Home Pearls: Rates of clinical inertia in the treatment of hypertension appear to be high. Important patient characteristics are associated with clinical inertia and may be targets for future interventions.
Gender Affects Hypertension Thresholds
The Particulars: Current ambulatory blood pressure (BP) thresholds for diagnosing hypertension do not differ between genders. However, women tend to have lower ambulatory BPs than men.
Data Breakdown: In a study, investigators assessed the role of gender on the diagnostic thresholds for awake and asleep BP averages based on cardiovascular disease (CVD) outcomes. The maximum combined sensitivity and specificity corresponded to threshold cutoff values of 135/85 mm Hg for awake BP and 120/70 mm Hg for asleep BP for men. In terms of CVD risk, the corresponding values in women were 125/80 mm Hg for the awake BP and 110/65 mm Hg for the asleep BP averages.
Take Home Pearls: The threshold for diagnosing hypertension should be 10/5 mm Hg lower for ambulatory BP in women than in men. Current guidelines should consider revising standards in the future.
Patient Education & CVD Risk Perception
The Particulars: Drug therapy compliance is widely regarded as an integral part of effective hypertension treatment. Factors associated with compliance, however, are poorly understood. Furthermore, interventions to address these factors are lacking.
Data Breakdown: A randomized trial was conducted in which participants received either usual care or enhanced knowledge of their own estimated risk of cardiovascular disease (CVD) and stroke. The authors also analyzed the effect of using patient education on blood pressure (BP) management at decreasing risk. Those who received the intervention trended toward having lower BPs at 12 months. They also perceived their CVD and stroke risk as lower than that of the control group.
Take Home Pearl: Patients who are educated by their physicians about hypertension appear to have improved compliance with BP medications and better BP control when compared with those who receive usual care.